Reduction by external fixator, or distractor
Especially with multifragmentary fractures, the use of an external fixator, or distractor, can provide alignment and temporary stability for bridge plating without disturbing the soft tissues at the fracture zone.
Proximal and distal pins should be inserted carefully in order not to interfere with the later plating procedure. For this purpose, the safe positions are anterolaterally, or anteriorly, on the femur.
If no traction table is used, folded linen bolsters under the fracture zone may facilitate reduction.